Gestational choriocarcinoma
Por:
Bogani G., Ray-Coquard I., Mutch D., Vergote I., Ramirez P.T., Prat J., Concin N., Ngoi N.Y.L., Coleman R.L., Enomoto T., Takehara K., Denys H., Lorusso D., Takano M., Sagae S., Wimberger P., Segev Y., Kim S.I., Kim J.-W., Herrera F., Mariani A., Brooks R.A., Tan D., Paolini B., Chiappa V., Longo M., Raspagliesi F., Benedetti Panici P., Di Donato V., Caruso G., Colombo N., Pignata S., Zannoni G., Scambia G., Monk B.J.
Publicada:
27 sep 2023
Ahead of Print:
1 ene 2023
Resumen:
Gestational choriocarcinoma accounts for 5% of gestational trophoblastic neoplasms. Approximately 50%, 25%, and 25% of gestational choriocarcinoma occur after molar pregnancies, term pregnancies, and other gestational events, respectively. The FIGO scoring system categorizes patients into low (score 0 to 6) and high risk (score 7 or more) choriocarcinoma. Single-agent and multi-agent chemotherapy are used in low- and high-risk patients, respectively. Chemotherapy for localized disease has a goal of eradication of disease without surgery and is associated with favorable prognosis and fertility preservation. Most patients with gestational choriocarcinoma are cured with chemotherapy; however, some (<5.0%) will die as a result of multi-drug resistance, underscoring the need for novel approaches in this group of patients. Although there are limited data due to its rarity, the treatment response with immunotherapy is high, ranging between 50-70%. Novel combinations of immune checkpoint inhibitors with targeted therapies (including VEGFR-2 inhibitors) are under evaluation. PD-L1 inhibitors are considered a potential important opportunity for chemo-resistant patients, and to replace or de-escalate chemotherapy to avoid or minimize chemotherapy toxicity. In this review, the Rare Tumor Working Group and the European Organization for Research and Treatment of Cancer evaluated the current landscape and further perspective in the management of patients diagnosed with gestational choriocarcinoma.
Filiaciones:
Bogani G.:
Fondazione IRCCS Istituto Nazionale Dei Tumori, Milano, Italy
University of Milan Bicocca, Milan, Italy
Ray-Coquard I.:
Centre Leon Berard, Lyon, Cedex 08, France
Hesper Lab, Université Claude Bernard Lyon 1, Villeurbanne, France
University of Milan Bicocca, Milan, Italy
Mutch D.:
Washington University in Saint Louis, St Louis, MO, United States
University of Milan Bicocca, Milan, Italy
Vergote I.:
Department of Gynecology and Obstetrics, Gynecologic Oncology, Leuven Cancer Institute, Catholic University Leuven, Leuven, Belgium
University of Milan Bicocca, Milan, Italy
Ramirez P.T.:
Department of Obstetrics and Gynecology, Houston Methodist Hospital, Houston, TX, United States
University of Milan Bicocca, Milan, Italy
Prat J.:
Department of Pathology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
University of Milan Bicocca, Milan, Italy
Concin N.:
Department of Gynecology and Obstetrics, Innsbruck Medical Univeristy, Innsbruck, Austria
University of Milan Bicocca, Milan, Italy
Ngoi N.Y.L.:
National University Cancer Institute, Singapore
University of Milan Bicocca, Milan, Italy
Coleman R.L.:
Sarah Cannon Research Institute, Nashville, TN, United States
University of Milan Bicocca, Milan, Italy
Enomoto T.:
Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
University of Milan Bicocca, Milan, Italy
Takehara K.:
Department of Gynecologic Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
University of Milan Bicocca, Milan, Italy
Denys H.:
Medical Oncology, University Hospital Ghent, Gent, Belgium
University of Milan Bicocca, Milan, Italy
Lorusso D.:
Policlinico Gemelli, Rome, Italy
University of Milan Bicocca, Milan, Italy
Takano M.:
Department of Obstetrics and Gynecology, National Defense Medical College, Tokorozawa, Japan
University of Milan Bicocca, Milan, Italy
Sagae S.:
Gynecologic Oncology, Tokeidai Kinen Byoin, Sapporo, Japan
University of Milan Bicocca, Milan, Italy
Wimberger P.:
Gyncology and Obstetrics, Technische Universitat Dresden Medizinische Fakultat Carl Gustav Carus, Dresden, Germany
University of Milan Bicocca, Milan, Italy
Segev Y.:
Obstetrics and Gynecology, Carmel Hospital, Haifa, Israel
University of Milan Bicocca, Milan, Italy
Kim S.I.:
Obstetrics and Gynecology, Seoul National University Hospital, Seoul, South Korea
University of Milan Bicocca, Milan, Italy
Kim J.-W.:
Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea
University of Milan Bicocca, Milan, Italy
Herrera F.:
Centre Hospitalier Universitaire Vaudois Departement Doncologie CHUV-UNIL, Lausanne, Switzerland
University of Milan Bicocca, Milan, Italy
Mariani A.:
Gynecologic Surgery, Mayo Clinic Rochester, Rochester, MI, United States
University of Milan Bicocca, Milan, Italy
Brooks R.A.:
Section of Gynecologic Oncology, University of Chicago Medicine, Chicago, IL, United States
University of Milan Bicocca, Milan, Italy
Tan D.:
National University Cancer Institute, Singapore
University of Milan Bicocca, Milan, Italy
Paolini B.:
Istituto Nazionale per Lo Studio e la Cura Dei Tumori, Milano, Italy
University of Milan Bicocca, Milan, Italy
Chiappa V.:
Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy
University of Milan Bicocca, Milan, Italy
Longo M.:
University of Insubria, Varese, Italy
University of Milan Bicocca, Milan, Italy
Raspagliesi F.:
Fondazione IRCCS Istituto Nazionale Dei Tumori, Milano, Italy
Surgery, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milano, Italy
University of Milan Bicocca, Milan, Italy
Benedetti Panici P.:
Obstetrics and Gynecology, University Sapienza of Roma, Rome, Italy
University of Milan Bicocca, Milan, Italy
Di Donato V.:
Department of Gynecology Obstetrics and Urological Sciance, Rome, Italy
University of Milan Bicocca, Milan, Italy
Caruso G.:
University of Rome la Sapienza, Rome, Italy
University of Milan Bicocca, Milan, Italy
Colombo N.:
Medical Gynecologic Oncology Unit, Milan, Italy
University of Milan Bicocca, Milan, Italy
European Institute of Oncology, Milano, Italy
Pignata S.:
University of Milan Bicocca, Milan, Italy
Gynaecological Oncology, National Cancer Institute Napels, Naples, Italy
Zannoni G.:
University of Milan Bicocca, Milan, Italy
Dipartimento Scienze della Salute della Donna e Del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
Scambia G.:
University of Milan Bicocca, Milan, Italy
Dipartimento Scienze della Salute della Donna e Del Bambino, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
Monk B.J.:
University of Milan Bicocca, Milan, Italy
Virginia G Piper Cancer Center-Biltmore Cancer Center, Phoenix, AZ, United States
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